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									                           CERTIFICATION REGARDING
           DEBARMENT, SUSPENSION, INELIGIBILITY, AND VOLUNTARY EXCLUSION
                                        for
                       LOWER TIER COVERED TRANSACTIONS
                              State of California HOME Investment Partnerships Program


This certification is required by the regulations implementing Executive Order 12549, Debarment and
Suspension, 29 CFR Part 98, Section 98.510, Participants’ Responsibilities. The regulations were published
as Part VII of the May 26, 1988 Federal Register (pages 19160 – 19211).

                       (BEFORE COMPLETING CERTIFICATION, READ THE INSTRUCTIONS)
(1) The prospective recipient of Federal assistance funds certifies, by submission of this proposal, that
    neither it nor its principals are presently debarred, suspended, proposed for debarment, declared
    ineligible, or voluntarily excluded from participation in this transaction by any Federal department or
    agency.

(2) Where the prospective recipient of Federal assistance funds is unable to certify to any of the
    statements in this certification, such prospective participant shall attach an explanation to this
    proposal.

                   Name of Organization/Business (prospective recipient of Federal assistance funds) – print


       Name of Authorized Representative - print                      Title of Authorized Representative - print


       Signature                                                      Date (MM/DD/YY)

                          INSTRUCTIONS FOR CERTIFICATION REGARDING DEBARMENT
By signing and submitting this proposal, the prospective recipient of Federal assistance funds is providing the certification as set out
below:
1. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was
   entered into. If it is later determined that the prospective recipient of Federal assistance funds knowingly rendered an erroneous
   certification, in addition to other remedies available to the Federal government, the Department of Labor (DOL) may pursue
   available remedies, including suspension and/or debarment.
2. The prospective recipient of Federal assistance funds shall provide immediate written notice to the person to which this proposal
   is submitted if at any time the prospective recipient of Federal assistance funds learns that its certification was erroneous when
   submitted or has become erroneous by reason of changed circumstances.
3. The terms “covered transaction” “debarred”, “suspended,” “ineligible,” “lower tier covered transaction,” “participant,” “person,”
   “primary covered transaction,” ”principal,” “proposal,” and “voluntarily excluded,” as used in this clause, have the meanings set
   out in the definitions and coverage sections of rules implementing Executive Order 12549. You may contact the person to which
   this proposal is submitted for assistance in obtaining a copy of those regulations.
4. The prospective recipient of Federal assistance funds agrees by submitting this proposal that, should the proposed covered
   transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,
   suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the
   DOL.
5. The prospective recipient of Federal assistance funds further agrees by submitting this proposal that it will include the clause
   titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion – Lower Tier Covered Transactions,”
   without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions.
6. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction
   that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the
   certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its
   principals. Each participant may, but it is not required to, check the List of Parties Excluded from Procurement or Non-
   procurement Programs.
7. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good
   faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which
   is normally possessed by a prudent person in the ordinary course of business dealings.
8. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transactions knowingly
   enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from
   participation in this transaction, in addition to other remedies available to the Federal government, the DOL may pursue available
   remedies, including suspension and/or debarment.


                     State of California: Department of Housing and Community Development (Rev. 01/09)

								
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